A353 p= 0.03), use of 3rd generation SU ; p= 0.002), and chronic renal disease ; p= 0.01). ConClusions: In conclusion, multiple factors, including efficacy and hypoglycemia, are associated with discontinuation of SU treatment after insulin initiation.objeCtives: Sulfonylurea (SU) may be discontinued or down-titrated due to hypoglycemia. Hypoglycemia may be more concerning for patients not receiving aggressive efficacy-driven treatment such as the dual-therapy of SU and insulin. A retrospective cohort study using the MarketScan database was conducted to assess the association between hypoglycemia and therapy changes (discontinuation or down-titration) among adults receiving SU therapy without insulin. Methods: Patients with the first SU prescription (Rx) (index date) in 2009-2011, ≥ 18 years of age on the index date, and with ≥ 1 year continuous enrollment pre-and postindex were included. Patients were excluded if they received insulin within the 1-year pre-or post-index, had ≥ 2 SUs on the index date, or had type 1, gestational or secondary diabetes. Therapy changes were determined during the 1-year postindex period. Discontinuation occurred when consecutive SU fills were ≥ 90 days apart. Down-titration occurred when an SU fill had a lower equivalent dose than the index dose. Hypoglycemic events were identified using ICD-9 code between the index date and the therapy change or the end of the 1-year post-index period. Cox regression was used to evaluate the association between hypoglycemic events and therapy changes. Results: 97,570 patients were included in the study, of which 50,854 (52.1%) experienced therapy changes within 1-year post-index. Patients with hypoglycemic events were at significantly higher risk for therapy changes (HR= 1.86 [1.75, 1.97]; p< . 01). Specifically, they were 197% more likely to down-titrate (HR= 2.97 [2.53, 3.46]; p< . 01) and 80% more likely to discontinue (HR= 1.80 [1.69, 1.92]; p< . 01). ConClusions: Post-index hypoglycemic events are significantly associated with therapy changes among patients receiving SU without insulin, especially down-titration. PDB122 guIDelIne aDHerence anD control of DIaBetes mellItus wItH co-morBIDItIes In a tertIary-care HosPItal In malaysIa
A601factors, potentially related with the mentioned respiratory diseases prevalence, as age, sex, smoking habits were analyzed. Four groups were compared: 1) asthma patients, 2) COPD patients, 3) patients with other chronic conditions, and 4) global Spanish population. Results: Data from 21,007 adults was recorded. Prevalence of asthma was slightly above COPD (5.4% vs 4.7%), and 47.2% were suffering from chronic diseases. Asthma patients were younger than those with COPD (51y vs 61y, as an average, respectively). Concerning EQ-5D results, the dimensions mainly affected either in COPD or asthma were, respectively, pain/discomfort (53.7% / 38.7%), mobility (42% / 27.4%), usual activities (34.4% / 21.8%), and depression/anxiety (32.4% / 25.4%). Based on the EQ-5D questionnaire, the QALYs calculation were 0.75 for COPD and 0.90 for asthma patients, the latter results were similar to the other chronic conditions and to the global population. Health resources in COPD patients were significantly higher than in the other 3 groups analyzed, considering office visits (GPs/Specialists), hospitalization and emergency unit visits during the last year. ConClusions: Patients diagnosed with asthma have a similar HRQOL compared to the rest of the population, but COPD patients have it worse. COPD is also associated with a higher health resources consumption, which implies a relevant impact on the Spanish National Health System. PRS76objeCtives: As young students are more prone to smoking and associated dangers it affects their health related quality of life (HRQoL). This study was done to assess the HRQoL and other associated factors affecting HRQoL among smokers and non-smokers who are students. Methods: In this exploratory study a pilot tested questionnaire was used to collect information regarding young students, demographics, BMI, food habits, alcohol consumption, family history of smoking as well as family history of diseases. For health related quality of life measurement both descriptive and visual analogue score (VAS) of EQ 5D 5L questionnaire ware used. The data collected was analyzed using SPSS 16.0.0. The test of significance was done by using Chi Square test for checking the associated habits and Mann Whitney U test is done to check the significance of association between HRQoL and smoking and other associated habits. Results: Total 126 students were included in the study. The age was 22.9±2.17 (Mean±SD) and BMI was 22.03±4.27 (Mean±SD) and all of them were residing in an University town. 63 % of the students were non-vegetarians and 44.8% were consuming alcohol at least once in a month. The mean EQ 5D visual analogue score of the studied population was found to be 83.3±11.5 (Mean±SD). The Chi square test showed the association between smoking with family history of smoking, alcohol consumption and soft drinks consumption (p< 0.001, 0.001 and 0.05 respectively). Mann Whitney U test showed as significant difference in the VAS scores among smokers and non-smokers (p< 0.05). ConClusions: Health Related Quality of Life is ...
A591(MPR) and Single Tablet Regimens (STR). Validated and self-reported questionnaires (ISS-QoL, EQ-5D-3L and CES-D) were administered to collect social and clinical data, QoL measure and adherence information, both at baseline and follow-up (6 months). The correlations between i) perceived QoL and the above mentioned variables, ii) determinants and/or predictors of the QoL, were investigated. Results: 300 questionnaires were delivered and 174 were completed. MPR and STR populations were comparable for all personal details, with similar immunological and virological effectiveness. Patients receiving STR declared a higher QoL than individuals using MPR (P= 0.004). Non-adherence, depression, lack of wellbeing and higher number of comorbidities lead to worse QoL (P< 0.05). The predictors of QoL in HIV-infected individuals were duration of HIV infection (P= 0.00), wellbeing measures (P= 0.01), years of treatment (P= 0.007) and viral load (P= 0.003). ConClusions: Although literature showed that QoL depends on CD4 count, the results of our study suggested that in the Italian setting, immunological effectiveness is not a determinant and a predictor of QoL variation. Regimen treatment impacts on adherence and compliance: simplification strategies could improve QoL patients perception.
Quality (AHRQ) comparative effectiveness report on treatments for seasonal allergic rhinitis, which used a non-anchor based approach. Results: Using the most conservative estimates provided within the approved prescribing information, the change in rTNSS from baseline was -1.18 (p = 0.02) for azelastine hydrochloride, -1.35 (p = 0.014) for ciclesonide, -1.47 (p < 0.001) for fluticasone furoate, and -2.7* for MP29-02 †(p < 0.001). Direct anchor-based estimates of MCID derived by Barnes and colleagues ranged from 0.28 units (95% CI: -0.18 to 0.73) and 0.23 units (95% CI: -0.16 to 0.62). Comparison of the anchor-based MCID threshold to the observed treatment indicates a positive clinical benefit for each treatment option. In contrast, the AHRQ report concluded that treatment options were equivalent to each other, to intranasal corticosteroids and to placebo, in contrast to common patient beliefs. ConClusions: Anchor based methods are critical in evaluating MCID as demonstrated by comparison of outcomes across intranasal products for seasonal allergic rhinitis. MCID methods need to be considered when evaluating evidence for health technology assessments. * Range of rTNSS is 0-12; 0-24 for MP29-02 † Dymista® = US trade name of MP29-02 PRM111 Can't we just use this PoRtuguese tRanslation in bRazil? analysing why theRe is MoRe to CountRy-sPeCifiC PRos than tiCking/CheCking boxes
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